Joint Replacement Health Article

Definition

Joint replacement is the surgical replacement of a joint with an artificial prosthesis.

Purpose

Great advances have been made in joint replacement since the first hip replacement was performed in the United States in 1969. Improvements have been made in the endurance and compatibility of materials used and the surgical techniques to install artificial joints. Custom joints can be made using a mold of the original joint that duplicate the original with a very high degree of accuracy.

The most common joints to be replaced are hips and knees. There is ongoing work on elbow and shoulder replacement, but some joint problems are still treated with joint resection (the surgical removal of the joint in question) or interpositional reconstruction (the reassembly of the joint from constituent parts).

Seventy percent of joint replacements are performed because arthritis has caused the joint to stiffen and become painful to the point where normal daily activities are no longer possible. If the joint does not respond to conservative treatment like medication, weight loss,

activity restriction, and use of walking aids such as a cane, joint replacement is considered appropriate.

Patients with rheumatoid arthritis or other connective tissue diseases may also be candidates for joint replacement, but the results are usually less satisfactory in those patients. Elderly people who fall and break their hip often undergo hip replacement when the probability of successful bone healing is low.

More than 170,000 hip replacements are performed in the United States each year. Since the lifetime of the artificial joint is limited, the best candidates for joint replacement are over age 60.

Precautions

Joint replacements are performed successfully on an older-than-average group of patients. People with diseases

that interfere with blood clotting are not good candidates for joint replacement. Joint replacement surgery should not be done on patients with infection, or any heart, kidney or lung problems that would make it risky to undergo general anesthesia.

Description

Joint replacements are performed under general or regional anesthesia in a hospital by an orthopedic surgeon. Some medical centers specialize in joint replacement, and these centers generally have a higher success rate than less specialized facilities. The specific techniques of joint replacement vary depending on the joint involved.